Cipro and Kids: What You Need To Know
Submitted by Dr. Gwenn Is In
I learned about the FDA black box warning on Cipro yesterday from a friends who emailed me asking “isn’t this one of the antibiotics used for ear infections?” Great question because it is - at least in drop form. Many kids who get ear tubes placed are given Cipro or a cousin of Cipro for ear infections and I can see where this report would be alarming to them. What did I tell my friend? Reports like this typically refer to “systemic use” of the antibiotics - meaning the child has to take the oral form of the medication.
We don’t use these medications in children often but sometimes do in older kids and teens for urinary tract infections and in kids who have certain chronic conditions to treat some unusual infections so it is important for you to have this information.
Here are the highlights:
- The warning is for an increased risk of tendonitis and tendon rupture while taking one of the following fluoroquinolone antibiotics: Cipro, Floxin, Factive, Avelox, Levaquin, Noroxin, and, the generics of these drugs.
- This warning applies only to “systemic use” - people have to swallow the medication. The eye and ear forms of the medication are still safe.
- The tendon rupture is usually preceded by symptoms such as pain and swelling of the tendon and is preventable if the medication is stopped as the first sign of these symptoms.
- The Achilles tendon behind the ankle is the usual location for this type of tendon rupture but there have been reports of hand and shoulder tendon ruptures.
- The risk is highest in people over 60, people on steroids, and in people with kidney, heart and lung transplants.
- Patients taking these medications need to alert their doctors at the first sign of any muscle or tendon pain, stop taking the medication and not over exert those areas of the body.
This doesn’t mean you can never use Cipro or one if its cousins again. It just means we have to be very, very thoughtful - more than usual. This warning also underscores the need to be judicious about antibiotic in general. These medications have an important role in healthcare but we have to be careful that the benefits outweigh the risks.
